MEDICARE: DR. ERIC J GRIESER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	35.084805	OH
2	207W00000X	Ophthalmology Physician	35.084805	OH
3	207W00000X	Ophthalmology Physician	64380	GA
4	207W00000X	Ophthalmology Physician	ME107767	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407846330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC J GRIESER MD

Provider Business Mailing Address
First Line	:	PO BOX 100284
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32610-0284
Country	:	US
Telephone Number	:	352-273-8778
Fax Number	:	352-273-7402

Provider Business Practice Location Address
First Line	:	2000 SW ARCHER RD
Second Line	:	SUITE 4500
City	:	GAINESVILLE
State	:	FL
Zip	:	32608-1136
Country	:	US
Telephone Number	:	352-265-7080
Fax Number	:	352-265-7081

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2005
Last Update Date	:	06/01/2020

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